May 30, 2005

Under The Knife

The Prior Injury

by Will Carroll

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For Memorial Day, let's pause a moment and thank everyone that is fighting or has fought for our freedom.

Powered by those heroes, on to the injuries ...

• Digging through textbooks and online references is something that can elucidate injuries or simply send me head-first into a bottle of tequila. As often as these resources explain things, just as often they leave me confused.

  The latest case of this is the "compression fracture" suffered by Mark Prior. Before starting a new round of DMPUs, I wanted to have the facts right. Prior's arm went from bruised but "something" on Friday to a stress fracture on Saturday. The latest diagnosis comes from the MRI done late Friday. A compression fracture is defined as one where the "bone collapses in on itself under some stress, usually external." That doesn't sound good, but is certainly understandable in this case. Most cases involve osteoporosis or other odd sounding things like Monteggia's fracture. The fracture in Prior's arm is in the ulna, the large bone on the side opposite the thumb, and a couple inches below the olecranon (point of elbow). The location is a definite plus; had the ball hit the olecranon, there would likely have been soft tissue damage and it's quite possible that the bone would have shattered, a career-threatening condition.

  All that aside, the real question most have is about how much time Prior will miss. While some reports say that he could begin throwing as soon as he is pain-free and has full range of motion, that appears to be oversimplifying things. Not only will Prior need those things, he'll need to have an ulna that is structurally sound. The first sign of an imminent return will be a MRI that clears his arm, followed by a throwing program that will vary depending on how long it takes the arm to further heal. Best guess? Two months to a return.

• Any speculation that John Smoltz was struggling because he'd been asked to move back to the bullpen is just that: speculation. According to braves.com, he's been dealing with a mild oblique strain, but this is the first mention of this. Coming off a mid-back strain and with his chronically troublesome pitching arm, I have to say that this seems a bit dubious. Given the top-notch medical staff the Braves have--including the criminally underrated Dr. Joe Chandler--I'll buy in and say to watch Smoltz for the effects for a couple starts.

  The news is clearer for Mike Hampton. A second side session on Sunday went much better than his Friday throw. He's expected to start on Tuesday, though Cox and Mazzone aren't writing his name in pen just yet.

• The Blue Jays had to be happy after Roy Halladay came back strong. Not just strong, not just really strong, but two-hitter, making-people-look-goofy strong. Halladay's mechanics looked slightly different, though I couldn't pick out why and my lack of high-speed access prevents me from watching it over and over. Halladay still bears watching over the next couple starts to be sure he's clear of any recurrences with that throw-side oblique muscle.

• The Marlins are simply a better team when A.J. Burnett can contribute. It's hard to imagine how any team could be worse with his electric stuff in the rotation. Of course, he has to be in the rotation to count, something he'll be able to do come Tuesday. Burnett had his last test on Saturday, throwing a full bullpen, and came out Sunday without the problematic inflammation. Going against Pittsburgh should help. Watch to see if Burnett is more efficient early.

• Remember when Curt Schilling was in Indianapolis and I said his ankle looked wobbly? Turns out I should have listened to myself more. That's been the problem all along. Schilling is working with everyone from cobblers to biomechanists and doctors to try and come up with a solution that will solidify his drive leg as he brings his knee up. The simple solution would be to reduce the knee lift, but that would place significantly more strain on his arm. As we learned from Eric Gagne (who's still off by a couple miles an hour), the slightest change in mechanics can have broad consequences. Finding the right answer for Schilling will take time, something the Red Sox have.

• The White Sox will have Frank Thomas back in the lineup next time they take the field. Robert Portnoy, one of our BPR correspondents who you'll hear this week, told us that Thomas is still bothered by the foot/ankle problem when he's running. That forces Thomas to DH and pushes Carl Everett to the outfield. If anything, Ozzie Guillen has more options now, rather than fewer. Thomas will need some time off, especially if the soreness flares up with running or standing, and likely could benefit from regular days off. Thomas might be swinging for the fences more, knowing that doubles are going to be a problem.

• There's a reason why players don't treat themselves and why we don't often take their word about their injuries. No matter what they say, they're likely to skew things to one extreme or the other: It's either as good as new or worse than ever. Patience is next to zero, and let's face it, not many players have "ATC" behind their name.

  The latest lesson in not listening comes from Vladimir Guerrero. The Angel is not back in the outfield and is not even swinging a bat, making a return at the minimum unlikely. Sources tell me that Guerrero is still guarding the shoulder and has lost both strength and range of motion post-injury. This looks to be something that will last for at least two more weeks, depending on how his shoulder responds to treatment. (By the way, please note that the blame of Scioscia was in the e-mail I printed Friday, not from me. I don't edit e-mails.)

• The A's have enough problems now, so any good news--like getting Bobby Crosby and Rich Harden back--has to help. Harden is "well ahead" of his rehab schedule, according to published quotes from trainer Larry Davis. The worry is that he'd push the oblique too hard, but since he's throwing long toss without pain, that's a very good sign. Watch for more focused workouts leading up to a return. Crosby is expected to return Monday, assuming he can pass one last test, facing simulated pitching. The bad news is that Octavio Dotel is still having no progress with his elbow and wants to see Jim Andrews. That will happen soon; perhaps we'll know more about a return date after that.

• There's no doubt that catchers have a significantly different physical load than most players. All--yes, all--of them show some signs of deterioration over the course of a season. It doesn't always show up in a specific way, such as their hitting or their speed, but ask any athletic trainer and they will say that the catchers need more treatment, more watching, and often, more painkillers to get through the season.

  Paul Lo Duca has often been accused of breaking down in the second half. This year, he's doing it a bit early, the victim of a series of HBP to his hip and elbow. Joe Mauer isn't having trouble with his knee, but there are those that think that his groin problem might be the result of a slightly different gait and crouch. Mauer's long been an advocate of the "knee saver" pads; this season, I'm told, he's using a bigger pad. Small changes can have big consequences.

• Raul Mondesi was a nice gamble by the Braves. There were no reports he was a clubhouse problem under Bobby Cox, it's just that he was never able to get himself physically right. His recent knee problems were, according to Mondesi, partially the fault of last season's quadriceps strain. Mondesi is being given the opportunity to retire with his head up rather than be cut. It's indicative of the organization's thinking that the DL wasn't a possibility.

• Quick Cuts: Troy Percival is on track for a return early next week. He'll have two throwing sessions this week, so watch for any setbacks … Conventional wisdom has Danny Graves going untraded through his DFA limbo. There will be some interest once the Reds are on the hook for the contract. Graves may also follow D'Angelo Jimenez to the minors … The Nationals aren't counting on getting 2B Jose Vidro back until the All-Star break … Alex Rodriguez a choker? The other team has put some bulletin-board material on the home-run leader … Carlos Beltran should be back in the lineup early this week, though the steals and speed he brought will remain on the shelf a bit longer, Mets fans.

Enjoy your holiday, folks.